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https://www.readbyqxmd.com/read/28379458/mid-term-results-of-bicuspid-aortic-valve-repair-guided-by-morphology-and-function-assessment
#1
Khalil Fattouch, Marco Moscarelli, Sebastiano Castrovinci, Giacomo Murana, Pietro Dioguardi, Francesco Guccione, Giuseppe Nasso, Giuseppe Speziale, Patrizio Lancellotti
OBJECTIVES: Bicuspid aortic valve (BAV) is frequently associated with aortic insufficiency (AI) due to cusp disease and/or aortic root dilatation. Based on functional classification and morphology, a systematic surgical approach was used for aortic valve repair (AVr). METHODS: : From 2004 to 2014, 152 consecutive patients (mean age 55 ± 7 years) with BAV underwent AVr with or without concomitant aortic root surgery. Cusp pathology was treated with central plication in 60 (39...
April 3, 2017: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/28366467/aortic-root-replacement-for-children-with-loeys-dietz-syndrome
#2
Nishant D Patel, Diane Alejo, Todd Crawford, Narutoshi Hibino, Harry C Dietz, Duke E Cameron, Luca A Vricella
BACKGROUND: Loeys-Dietz syndrome (LDS) is an aggressive aortopathy with a proclivity for aortic aneurysm rupture and dissection at smaller diameters than other connective tissue disorders. We reviewed our surgical experience of children with LDS to validate our guidelines for prophylactic aortic root replacement (ARR). METHODS: We reviewed all children (younger than 18 years) with a diagnosis of LDS who underwent ARR at our institution. The primary endpoint was mortality, and secondary endpoints included complications and the need for further interventions...
March 30, 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28355759/-clinical-practice-and-thoughts-on-the-strategy-of-root-reconstruction-for-stanford-type-a-aortic-dissection
#3
C S Wang, J Li, H Lai
The strategy of root reconstruction for Stanford type A aortic dissection (AAD) includes resection of the intimal tear site, correction of concomitant aortic valve dysfunction and amendment of coronary lesion. Supracommissural tube graft replacement is a well-adopted and convenient procedure for most patients, although its application is limited when distinct sinus expansion and severe intimal damage is present. Composite valve conduit replacement (Bentall procedure) is suitable for patients with overt sinus damage...
April 1, 2017: Zhonghua Wai Ke za Zhi [Chinese Journal of Surgery]
https://www.readbyqxmd.com/read/28329461/cardiac-function-after-tetralogy-of-fallot-complete-atrioventricular-canal-repair
#4
Elizabeth H Stephens, Jennifer Tingo, Marc Najjar, Betul Yilmaz, Stéphanie Levasseur, Jeffrey D Dayton, Ralph S Mosca, Paul Chai, Jan M Quaegebeur, Emile A Bacha
BACKGROUND: Repair of complete atrioventricular canal (CAVC) with tetralogy of Fallot (TOF) is a challenging operation increasingly being performed as a complete, primary repair in infancy. Previous studies have focused on perioperative outcomes; however, midterm valve function, ventricular function, and residual obstruction have received little attention. METHODS: We retrospectively reviewed 20 patients who underwent CAVC/TOF repair (January 2005 to December 2014)...
March 2017: World Journal for Pediatric & Congenital Heart Surgery
https://www.readbyqxmd.com/read/28329237/extensive-infective-endocarditis-of-the-aortic-root-and-the-aortic-mitral-continuity-a-mitral-valve-sparing-approach%C3%A2
#5
Anton Tomšic, Adriaan W Schneider, Meindert Palmen, Thomas J van Brakel, Michel I M Versteegh, Robert J M Klautz
OBJECTIVES: Severe cases of infective endocarditis (IE) of the aortic valve can cause aortic root destruction and affect the surrounding structures, including the aortic-mitral continuity, the anterior mitral valve leaflet and the roof of the left atrium. Reconstruction after resection of all infected tissue remains challenging. We describe our surgical approach and the mid-term results. METHODS: Between January 2004 and December 2015, 35 patients underwent surgery for extensive IE of the aortic valve with destruction of the aortic root, the aortic-mitral continuity and the mitral valve...
February 23, 2017: European Journal of Cardio-thoracic Surgery
https://www.readbyqxmd.com/read/28329094/biological-solutions-to-aortic-root-replacement-valve-sparing-versus-bioprosthetic-conduit%C3%A2
#6
Mario Gaudino, Antonino Di Franco, Lucas B Ohmes, Luca Weltert, Christopher Lau, Ivancarmine Gambardella, Andrea Salica, Monica Munjal, Mohamed Elsayed, Leonard N Girardi, Ruggero De Paulis
OBJECTIVES: Valve-sparing operations and root replacement with a biologic composite conduit are viable options in aortic root aneurysm. This study was conceived to compare the early and mid-term results of these 2 procedures. METHODS: From September 2002 to November 2015, 749 consecutive patients underwent either a valve-sparing operation or a root replacement with a biologic composite conduit at 2 institutions. Propensity score matching was used to compare similar cohorts of patients in the overall population and in the ≤ 55 and ≥ 65-year age groups...
February 17, 2017: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/28320511/malrotated-sinus-vortices-in-straight-graft-valve-sparing-aortic-root-treatment-a-matter-of-concern
#7
EDITORIAL
Thekla H Oechtering, Alex Frydrychowicz, Hans-Hinrich Sievers
No abstract text is available yet for this article.
February 21, 2017: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/28281042/valve-sparing-aortic-root-re-implantation-for-commissural-detachment-with-fibrous-strand
#8
Seiji Matsukuma, Taku Inoue, Kazuyoshi Tanigawa, Takashi Miura, Ichiro Matsumaru, Mizuki Sumi, Takeshi Murakami, Kikuko Obase, Kiyoyuki Eishi
Both aortic valve commissural detachment and commissural fenestration are rare causes of aortic regurgitation. In general, aortic valve replacement is the mainstay treatment for aortic regurgitation caused by commissural detachment or commissural fenestration. We herein describe valve-sparing aortic root re-implantation and aortic valve repair for aortic regurgitation and aortic root dilatation in an extremely rare case accompanied by both commissural detachment and commissural fibrous strand of fenestrated cusp...
March 9, 2017: General Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/28269006/prediction-of-individual-prosthesis-size-for-valve-sparing-aortic-root-reconstruction-based-on-geometric-features
#9
J Hagenah, E Werrmann, M Scharfschwerdt, F Ernst, C Metzner
Valve-sparing aortic root reconstruction is an up- and-coming approach for patients suffering from aortic valve insufficiencies which promises to significantly reduce complications. However, the success of the treatment strongly depends on the challenging task of choosing the correct size of the prosthesis, for which, up to now, surgeons solely have to rely on their experience. Here, we present a novel machine learning based approach, which might make it possible to predict the size of the prosthesis from pre-operatively acquired ultrasound images...
August 2016: Conference Proceedings: Annual International Conference of the IEEE Engineering in Medicine and Biology Society
https://www.readbyqxmd.com/read/28268005/feasibility-of-intraoperative-water-testing-in-aortic-valve-repair-direct-visualization-from-left-ventricle-with-a-videoscope
#10
Shunsuke Miyahara, Takanori Oka, Hiroaki Takahashi, Takeshi Inoue, Masamichi Matsumori, Hiroshi Tanaka, Yutaka Okita
OBJECTIVE: We describe a simple method to assess the aortic valve using a videoscope inserted in the left ventricle (LV-VS) during valve-sparing root replacement. The aim of this study was to evaluate the feasibility of this technique by comparing it with the findings of postoperative transesophageal echocardiography (TEE). METHODS: Thirty-six patients (29 male, mean age 45.4 ± 20.1 years) undergoing aortic root reimplantation were assessed intraoperatively with LV-VS...
February 10, 2017: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/28259111/evidence-based-surgery-of-aortic-regurgitation-results-of-a-questionnaire-in-german-speaking-countries
#11
Christian Dinges, Johannes Steindl, Wolfgang Hitzl, Tobias Kiesslich, Rainald Seitelberger
Background evidence-based medicine (EBM) approaches have reached broad acceptance, both in conservative and surgical disciplines. The aim of this study is to clarify the role of EBM in a rare condition of aortic regurgitation (AR) with surgical indication. Methods A purpose-built Internet-based questionnaire was sent to 607 cardiovascular surgeons in Germany, Austria, and Switzerland. A virtual 64-year-old patient's medical history was presented, including two ultrasound images and one computed tomography scan, showing a 58-mm aortic root aneurysm and a severe trileaflet regurgitant aortic valve...
March 4, 2017: Thoracic and Cardiovascular Surgeon
https://www.readbyqxmd.com/read/28229270/should-the-annulus-be-fixed-in-aortic-valve-sparing-root-replacement-with-remodeling
#12
Kojiro Furukawa, Keiji Kamohara, Junji Yunoki, Shugo Koga, Manabu Itoh, Hiroyuki Morokuma, Yosuke Mukae, Tsuyoshi Itoh, Shigeki Morita
OBJECTIVES: If the aortic root dilates after native aortic valve-sparing root reconstruction with remodeling, aortic regurgitation may recur. However, it has not been demonstrated clearly that the aortic root dilates after remodeling. METHODS: This study enrolled 15 patients who underwent an aortic valve-sparing operation with remodeling (2002-2014) but without any ventriculo-aortic junction (VAJ) fixation. Technically, special care was taken to pass the sutures through the fibrous annulus...
April 2017: General Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/28227216/prediction-of-individual-prosthesis-size-for-valve-sparing-aortic-root-reconstruction-based-on-geometric-features
#13
J Hagenah, E Werrmann, M Scharfschwerdt, F Ernst, C Metzner, J Hagenah, E Werrmann, M Scharfschwerdt, F Ernst, C Metzner, C Metzner, E Werrmann, J Hagenah, F Ernst, M Scharfschwerdt
Valve-sparing aortic root reconstruction is an up- and-coming approach for patients suffering from aortic valve insufficiencies which promises to significantly reduce complications. However, the success of the treatment strongly depends on the challenging task of choosing the correct size of the prosthesis, for which, up to now, surgeons solely have to rely on their experience. Here, we present a novel machine learning based approach, which might make it possible to predict the size of the prosthesis from pre-operatively acquired ultrasound images...
August 2016: Conference Proceedings: Annual International Conference of the IEEE Engineering in Medicine and Biology Society
https://www.readbyqxmd.com/read/28187973/remodeling-root-repair-with-an-external-aortic-ring-annuloplasty
#14
Emmanuel Lansac, Isabelle Di Centa, Ghassan Sleilaty, Stephanie Lejeune, Alain Berrebi, Pavel Zacek, Mathieu Debauchez
OBJECTIVE: Although the remodeling technique provides the most dynamic valve-sparing root replacement, a dilated annulus (>25 mm) is a risk factor for failure. Aortic annuloplasty aims to reduce the annulus diameter, thus increasing coaptation height to protect the repair. The results of 177 patients with remodeling and external aortic ring annuloplasty were studied. METHODS: Data were collected from the Aortic Valve repair InternATiOnal Registry. Preoperative aortic insufficiency grade 3 or greater was present in 79 patients (44...
May 2017: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/28168983/changes-in-operative-strategy-for-patients-enrolled-in-the-international-registry-of-acute-aortic-dissection-interventional-cohort-program
#15
Neil Parikh, Santi Trimarchi, Thomas G Gleason, Arnoud V Kamman, Marco di Eusanio, Truls Myrmel, Amit Korach, Hersh Maniar, Takeyoshi Ota, Ali Khoynezhad, Daniel G Montgomery, Nimesh D Desai, Kim A Eagle, Christoph A Nienaber, Eric M Isselbacher, Joseph Bavaria, Thoralf M Sundt, Himanshu J Patel
OBJECTIVE: Advancements in cardiothoracic surgery prompted investigation into changes in operative management for acute type A aortic dissections over time. METHODS: One thousand seven hundred thirty-two patients undergoing surgery for type A aortic dissection were identified from the International Registry of Acute Aortic Dissection Interventional Cohort Database. Patients were divided into time tertiles (T) (T1: 1996-2003, T2: 2004-2010, and T3: 2011-2016). RESULTS: Frequency of valve sparing procures increased (T1: 3...
January 9, 2017: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/28108566/total-aortic-arch-replacement-with-the-frozen-elephant-trunk-procedure-in-acute-debakey-type-i-aortic-dissections
#16
Malakh Shrestha, Axel Haverich, Andreas Martens
OBJECTIVES: In patients with acute aortic dissection involving the arch and the descending aorta (AADA DeBakey type I), performing a total aortic arch replacement with the frozen elephant trunk (FET) procedure for supposedly better long-term results is still controversial. METHODS: From February 2004 to April 2016, 94 patients with AADA DeBakey type I had an FET procedure (80% men, age 58 ± 12 years). During the early period (Group 1, 2004-10), the FET technique was performed using non-branched grafts...
January 2017: European Journal of Cardio-thoracic Surgery
https://www.readbyqxmd.com/read/28043991/partial-root-remodelling-for-treatment-of-a-giant-isolated-right-sinus-of-valsalva-aneurysm
#17
Makoto Hashimoto, Hirosato Doi, Ryuji Koshima, Satoshi Sumino
Sinus of Valsalva aneurysms are rare cardiac abnormalities that may be congenital or acquired. Patch closure or direct closure of the aneurysm orifice is a frequently performed surgical repair strategy. In this report, we present a rare case of an isolated giant right sinus of Valsalva aneurysm with aortic insufficiency and right coronary artery obstruction. We treated this patient by a valve-sparing aortic root remodelling procedure with partial preservation of the intact Valsalva sinuses and coronary artery bypass grafting with a favourable outcome...
May 1, 2017: European Journal of Cardio-thoracic Surgery
https://www.readbyqxmd.com/read/28043434/aortic-root-surgery-does-high-surgical-volume-and-a-consistent-perioperative-approach-improve-outcome
#18
Rajdeep Bilkhu, Pouya Youssefi, Gopal Soppa, Rajan Sharma, Anne Child, Mark Edsell, Jean-Pierre van Besouw, Marjan Jahangiri
There is evidence that high surgical volume and team consistency improve outcomes. Mortality of 4%-12% for aortic root surgery has been reported in the United States and UK. We aim to assess outcomes of patients undergoing aortic root surgery by a consistent, high-volume team. Data on patients undergoing elective or urgent aortic root replacement (ARR) were collected prospectively. Patients undergoing emergency surgery were excluded. A standardized perioperative approach was maintained and was achieved by delivering training to team members, including surgical trainees, anesthetic, nursing, and perfusion staff, whenever there was a change of team...
July 2016: Seminars in Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/28040766/valve-sparing-aortic-root-replacement-for-a-prolapsing-asymmetric-valve
#19
Daisuke Takahashi, Norihiko Shiiya, Naoki Washiyama, Katsushi Yamashita
Valve-sparing aortic root replacement remains challenging for patients with eccentric severe aortic regurgitation when the cusps are totally asymmetric. We report a case of successful reimplantation operation for such a lesion. Because free margin lengths from commissure to Arantius body of the adjacent two cusps were matched while inter-commissural distances were totally different, right coronary cusp prolapse was corrected by asymmetrically aligning the position and height of three commissures without cusp plication...
December 31, 2016: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/28040763/feasibility-and-clinical-outcome-after-minimally-invasive-valve-sparing-aortic-root-replacement
#20
Kristina Wachter, Ulrich F W Franke, Rashmi Yadav, Ragi Nagib, Adrian Ursulescu, Samir Ahad, Hardy Baumbach
OBJECTIVES: This study aims to examine the feasibility and clinical course after minimally invasive David procedure compared with those via a conventional median sternotomy. METHODS: One hundred and ninety-two consecutive patients who underwent elective valve-sparing aortic root replacement (David procedure) with or without additional cusp repair for aortic regurgitation (n = 17, 8.9%), dilatation of the aortic root (n = 95, 49.5%) or a combination of both pathologies (n = 80, 41...
December 31, 2016: Interactive Cardiovascular and Thoracic Surgery
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